Alcohol Use: Study Sheds Light On Abstainers' Higher Mortality Rate

Does low to moderate alcohol consumption really have health benefits? Other risk factors may be behind some abstainers' increased mortality risk, a new study has found.

Evidence from past studies suggested that those who abstain from drinking alcohol have a higher mortality rate compared to those who consume low to moderate amounts of it, the Public Library of Science (PLOS) noted in a news release.

"However, little is known about factors that might be causal for this finding," the researchers of a new study, published Tuesday in the journal PLOS Medicine, wrote.

For their study, the researchers looked at the other possible risk factors for why the abstainers have lower life expectancy compared to those who consume low to moderate levels of alcohol. To do this, they looked at a sample of 4,028 adults in northern Germany.

The participants were aged 18 to 64 years old when the researchers conducted interviews from 1996 to 1997, during which they gathered information on their health, including their alcohol consumption or abstinence in the past 12 months and drug use. Researchers then conducted a mortality follow-up 20 years later from April 2017 to April 2018.

There were 447 participants who said they had not consumed alcohol in the 12 months prior to the interview, 405 of whom were former consumers of alcohol while 322 also had one or more risk factors for higher mortality such as daily smoking, former alcohol abuse disorder or self-rated their health to be fair to poor.

For instance, among the abstainers with the risk factors, 114 had a history of risky alcohol consumption or alcohol abuse disorder, while 161 did not have an alcohol-related risk but smoked daily.

Mortality Risk Among Alcohol Consumers And Abstainers

The researchers found that the 322 participants who were alcohol-abstinent during the interview but had one or more risk factors "had shorter time to death" compared to the alcohol drinkers with low to moderate consumption. However, the other 125 participants who were alcohol abstinent and had no risk factors did not have a "statistically significant difference" with the low-to-moderate alcohol consumers in terms of total, cardiovascular and cancer mortality.

"It has long been assumed that low to moderate alcohol consumption might have positive effects on health based on the finding that alcohol abstainers seemed to die earlier than low to moderate drinkers," one of the study authors, Ulrich John of University Medicine Greifswald, Germany, said in the PLOS news release. "We found that the majority of the abstainers had alcohol or drug problems, risky alcohol consumption, daily tobacco smoking or fair to poor health in their history, i.e., factors that predict early death."

According to the researchers, this suggests that current alcohol abstinence in the general population doesn't automatically mean a shorter "survival time" compared to those who consume alcohol at low to moderate levels.

"Increased mortality risks among abstainers might largely be explained by previous alcohol or drug problems, risky drinking, daily smoking, and self-rated health as fair to poor," the researchers wrote.

"Healthy alcohol abstainers who have no alcohol- or tobacco-related risk factors may not have a higher mortality than low to moderate alcohol consumers," they noted. "The findings speak against recommendations to drink alcohol for health reasons."